Getting Disability Benefits for Cardiomyopathy

There are many types of cardiomyopathy--ischemic, dilated, hypertrophic, and restrictive, all of which can qualify for disability if severe.

Cardiomyopathy means disease of the heart muscle; depending on the type of cardiomyopathy, it can cause weakening, thickening, or enlarging of the heart muscle, which can lead to your heart's not being able to pump enough blood to the body. Cardiomyopathy can be caused by high blood pressure, viral infections, abuse of cocaine or alcohol (called alcoholic cardiomyopathy), coronary artery disease, end-state kidney disease, or systemic lupus, among other conditions.

Patients who suffer from cardiomyopathy symptoms can experience severe fatigue, swelling of the legs and feet, chest pain (angina), dizziness, fainting, irregular heartbeats, and shortness of breath with exercise, or in severe cases, even at rest.

Does Cardiomyopathy Qualify as a Disability?

Many patients, especially older people, suffer from some sort of cardiomyopathy, but not all of them are disabled. For many people, especially those under retirement age, heart medication can sufficiently control cardiomyopathies. Whether cardiomyopathy qualifies for benefits depends on how well the condition can be treated. For instance, if coronary artery bypass surgery can restore sufficient blood supply to the heart, symptoms of shortness of breath and fatigue usually improve, no longer making the cardiomyopathy a disabling condition. More simply, alcoholic cardiomyopathy can be improved with quitting drinking (if so, you won't qualify for disability; see our article on how alcohol use affects your disability claim).

Until recently, the SSA had a separate impairment listing for cardiomyopathies (4.08), but it simply directed patients to apply for disability under either chronic heart failure, ischemic heart disease, or arrhythmia. There is no longer an official SSA listing for cardiomyopathies, but you still must apply for disability under the listing for congestive heart failure (listing 4.02), ischemic (coronary) heart disease (4.04), or arrhythmia (4.05).

For instance, many patients with cardiomyopathy have congestive heart failure. (This doesn’t mean the heart stops, just that the heart can no longer pump blood to the body effectively.) Severe heart failure qualifies as a disability for Social Security benefits under listing 4.02.

Which SSA Impairment Listing Does My Cardiomyopathy Fall Under?

It can help to determine under which listing your condition will be evaluated to look at the types of cardiomyopathy. Here are some of the more common types.

Ischemic Cardiomyopathy

This type of cardiomyopathy is caused by coronary artery disease (narrowing of the arteries that supply the heart with blood, also called hardening of the arteries). Some doctors no longer consider this to be a type of cardiomyopathy, since the initial problem is the reduced blood flow through the coronary arteries; instead they consider the problem to be ischemic heart disease (where coronary artery disease causes a heart attack, which causes damage to the heart muscle). In any case, ischemic cardiomyopathy is often evaluated under ischemic heart disease, but where it causes heart failure, it will be evaluated under the SSA's "chronic heart failure" listing.

Dilated Cardiomyopathy

With this type of cardiomyopathy, the most common type of true cardiomyopathy, the left ventricle of the heart becomes enlarged and doesn’t pump as well. This can lead to congestive heart failure.

Hypertrophic Cardiomyopathy

This type of cardiomyopathy, usually genetic, causes thickening of the heart muscle, which shrinks the left ventricle and makes it harder for the heart to pump blood to the rest of the body. This can lead to cardiac arrhythmias (abnormal heart rhythms), but does not often lead to functional limitations that qualify for disability. In severe cases, however, it can lead to diastolic dysfunction and chronic heart failure.

Restrictive Cardiomyopathy

In this type of cardiomyopathy, the least common, the heart muscle becomes stiff and causes problems with the heart filling with blood. This can lead to diastolic dysfunction and congestive heart failure.